Digitization of Hand Hygiene Audits: Improving Compliance and Patient Safety

Background: Clinical audits are vital for upholding healthcare quality and patient safety. Traditional audits in India often rely on paper-based methods, limiting efficiency, timeliness, and compliance monitoring. Digitization of audits offers real-time analytics, streamlined reporting, and improved staff engagement. Objective: This study evaluates the effect of digitizing the Hand Hygiene Audit in a multispecialty tertiary care hospital group to assess its impact on compliance and infection control. Methods: A multicentre quasi-experimental pre–post study was conducted across four pilot hospital units in Bangalore, Kolkata, and Jaipur. Data were collected before and after implementation of a digital audit platform. Compliance was tracked using standardized audit templates, with results displayed on a centralized dashboard accessible to managers and quality teams. Findings: Overall hand hygiene compliance increased significantly from 58.0% (174/300) before digitization to 86.0% (258/300) after implementation, representing an absolute improvement of 28 percentage points (RR = 1.48, 95% CI: 1.33–1.65; P < 0.001). Similar statistically significant improvements were observed in intensive care units (52% to 82%; RR = 1.58; P < 0.001) and operation theatres (61% to 88%; RR = 1.45; P < 0.001). Audit frequency increased threefold, reporting turnaround time decreased from 15–30 days to <24 hours, audit coverage improved from 60% to 96% (RR = 1.60, 95% CI: 1.36–1.89; P < 0.001), staff participation increased from 40% to 80% (RR = 2.00, 95% CI: 1.50–2.67; P < 0.001), and data recording errors decreased from 12% to 2% (RR = 0.17, 95% CI: 0.07–0.39; P < 0.001), demonstrating significant improvements in audit efficiency, data quality, and accountability. Conclusion: Digitization of the Hand Hygiene Audit enhanced compliance, efficiency, and transparency. Wider adoption of such digital tools can standardize infection control practices across healthcare systems.